Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
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Comparative Study
Evaluating blunt abdominal trauma:role for ultrasonography.
Patients in unstable condition with suspected blunt abdominal trauma require rapid evaluation to assess the need for laparotomy. Ultrasonography is fast and uses portable equipment, and it can be used in the resuscitation area to detect free intraperitoneal fluid as an indication of intraabdominal injury in the patient in unstable condition. ⋯ Our results reveal that ultrasonography has a sensitivity of 87%, a specificity of 100%, and an overall accuracy of 96% for detecting free intraperitoneal fluid. We conclude that ultrasonography is a reliable method for the emergent evaluation of blunt abdominal trauma and can be used in place of diagnostic peritoneal lavage as the initial indicator of significant intraperitoneal injury requiring surgical intervention.
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We reviewed the ultrasonographic studies and the clinical course of 22 fetuses with supraventricular tachycardia to determine whether the heart rate alone could serve as a basis for conservative management. Hydrops was not encountered with heart rates under 230 beats per minute. ⋯ No fetal or neonatal losses occurred. Regardless of the type of supraventricular tachycardia, reducing heart rate in these fetuses to levels preventing or resolving hydrops allowed term vaginal delivery, thereby reducing the substantial problems of ventilating an immature or hydropic neonate.
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Using color and pulsed Doppler ultrasonography, the interobserver reliability of measurements in the fetal circulation was evaluated in 41 pregnancies of 25 to 39 weeks' gestation. Two observers recorded flow velocity waveforms from the middle cerebral and renal arteries for measurement of peak systolic, minimum diastolic, and mean velocities, pulsatility index, and resistive index. ⋯ Substantial interobserver agreement was found for pulsatility index and minimum diastolic velocity in both arteries. Therefore, these measurements have the greatest clinical applicability.
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The purpose of this work was to assess the functional dynamics and anatomy of the cardiac chambers and great vessels in the fetus (18 to 36 weeks) using in utero three-dimensional ultrasonographic imaging. Fifteen patients were studied using conventional two-dimensional sonographic equipment incorporating a position sensor attached to the transducer and a graphics workstation. Sonographic image data were acquired at 30 images per second and required less than 30 seconds per data set. ⋯ Three-dimensional sonographic imaging of the fetal heart provides both anatomic and functional information regarding the valves, myocardium, great vessels, and chamber dynamics. Interactive three-dimensional cinegraphic display enhances visualization of cardiac anatomy, which can be difficult to appreciate with two-dimensional methods. The methods presented in this work demonstrate the feasibility of three-dimensional fetal echocardiography.